The ABCD ² Score: Stratifying Risk for Stroke After TIA

After a transient ischemic attack (TIA), 4% to 20% of patients will have a stroke within the next 90 days — half within 48 hours. Which patients with TIAs are most likely to have early strokes and to merit urgent preventive intervention? Recently, groups in California and the U.K. devised similar scoring systems that accurately predicted stroke risk after TIA (Journal Watch Aug 12 2005). These groups now jointly present a combined system, termed the ABCD² score, which is more accurate than either of the original systems alone.

The seven-point ABCD² score is based on:

• Age (≥60 years = 1 point)

• Blood pressure at presentation (≥140/90 mm Hg = 1 point)

• Clinical features (unilateral weakness = 2 points, speech disturbance without weakness = 1 point)…